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Renin inhibitors, clinical experience

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Abstract

The inhibition of the renin–angiotensin system is one of the most commonly utilized ways to lower blood pressure in patients with arterial hypertension. Up till now, angiotensin-converting enzyme inhibitors as well as angiotensin receptor blockers are the established inhibitors of this system, and both classes are used in clinical routine. There is a wealth of information about those classes, which are known not only to lower blood pressure, but also to prevent end-organ damage and, ultimately, reduce mortality in patients. Direct renin inhibition was already targeted 30 years ago to inhibit the renin–angiotensin system, but low bioavailability and short duration of action of the first generations of renin inhibitors withheld their clinical success. With the new generation of non-peptide orally available renin inhibitors, a third substance to inhibit the renin–angiotensin system is on the market, and the prototype of this class, aliskiren, has now been tested in various clinical trials in arterial hypertension. We review the studies of aliskiren and discuss its current role in the contemporary treatment of arterial hypertension as well as the possible new fields of action for aliskiren in treating heart failure and diabetic nephropathy.

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Authors and Affiliations

  1. Department of Cardiology and Pneumology, Charité—Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Dirk Westermann, Heinz-Peter Schultheiss & Carsten Tschöpe

  2. Clinical Research Center, Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany

    Roland Schmieder

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  1. Dirk Westermann
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  2. Roland Schmieder
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  3. Heinz-Peter Schultheiss
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  4. Carsten Tschöpe
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Correspondence to Carsten Tschöpe.

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Westermann, D., Schmieder, R., Schultheiss, HP. et al. Renin inhibitors, clinical experience. J Mol Med 86, 691–695 (2008). https://doi.org/10.1007/s00109-008-0338-y

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  • DOI: https://doi.org/10.1007/s00109-008-0338-y

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